The split crest technique and dental implants: a systematic review and meta-analysis

This systematic review aimed to determine: (1) the expected bone volume gain with the split crest technique, and (2) how the use of surgical instruments affects the performance of this technique. An electronic search was performed in the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Embase, PubMed/MEDLINE, Scopus, and Web of Science databases. Twenty-seven articles met the selection criteria and were subjected to meta-analysis of bone gain and survival rate; 17 reported the use of conventional surgical instruments and nine the use of surgical ultrasound. A total of 4115 implants were installed in 1732 patients (average patient age 52 years). The overall implant survival rate was 97%. The average bone gain in studies that used conventional surgical instruments was 3.61mm, while this was 3.69mm in those that used ultrasound. Only two studies presented a low risk of bias. The greatest problems identified during the qualitative analysis were related to random selection of the population and the absence of statistical analysis. The split crest technique appears to be a promising and effective technique to gain bone width, regardless of the surgical instruments used. Considering the diversity of the studies and implant types, no definitive recommendations can be made, especially with regard to the best instruments and implant design to be used.

The participation of lipid-linked oligosaccharide in synthesis of membrane glycoproteins

Membrane preparations from hen oviduct catalyze the transfer of mannose from GDP-mannose into three components: mannosyl phosphoryl polyisoprenol, oligosaccharide-lipid, and glycoprotein. Eivence that mannosyl phosphoryl polyisoprenol serves as a mannosyl donor for synthesis of both oligosaccharide-lipid and glycoproteins was previously reported (Waechter, C.J., Lucas, J.J., and Lennarz, W.J. (1973) J. Biol. Chem. 248, 7570-7579). In this study the oligosaccharide-lipid has been isolated, and the oligosaccharide has been partially characterized. Based on paper chromatography the oligosaccharide chain contains 7 to 9 glycose units. The glycose at the reducing terminus is N-acetylglucosamine, whereas mannose is found at the nonreducing end. When UDP-N-acetyl[14C]glucosamine is incubated with oviduct membranes in the absence of GDP-mannose, a 14C-labeled chitobiosyl lipid, but little oligosaccharide-lipid is synthesized. When GDP-mannose is also present in the incubation mixture an oligosaccharide-lipid is formed containing N-acetyl[14C]glucosaminyl residues. This oligosaccharide-lipid is chromatographically identical with the [14C]mannose-containing oligosaccharide-lipid isolated in the earlier study cited above. When the N-acetyl[14C]glucosamine-oligosaccharide released from the oligosaccharide-lipid by mild acid is treated with partially purified alpha-mannosidase the major radioactive product is [14C]chitobiose. Evidence that the [14C]mannose-containing oligosaccharide-lipid serves as an oligosaccharide donor for glycoprotein synthesis was obtained by incubation of partially purified oligosaccharide-lipid with the membranes. The products of this incubation were shown to be glycoproteins on the basis of their sensitivity to pronase, as determined by both gel filtration and paper electrophoresis. Similar experiments, using oligosaccharide-lipid doubly labeled with [14C]mannose and N-acetyl[3H]glucosamine, provided evidence that the oligosaccharide chain of the oligosaccharide-lipid is transferred en bloc to glycoprotein s.